摘要
目的：观察维持性血液透析（MHD）患者的血管钙化情况,并分析相关检查结果,探讨影响MHD患者血管钙化的可能因素。方法：选取行MHD且透析时间〉3个月的患者102例,行腹部侧位平片观察腹主动脉钙化情况,提示腹主动脉钙化为钙化组,未发现腹主动脉钙化为非钙化组。心脏及颈部血管彩超检查观察2组心脏瓣膜钙化及颈动脉内膜中层厚度（IMT）,根据Kauppila法进行血管钙化评分,同时计算心血管钙化指数。并抽血检查血全段甲状旁腺激素、超敏C反应蛋白（hsCRP）、血常规、肝肾功能、血糖、血脂、血钙、血磷、碱性磷酸酶等生化指标。结果：钙化组年龄、透析龄、血磷、是否糖尿病肾病、hs-CRP、IMT与非钙化组差异均有统计学意义（P〈0.05~P〈0.01）。相关性分析研究发现年龄、透析龄、hs-CRP、血磷和IMT与血管钙化评分均呈正相关关系（P〈0.05~P〈0.01）。logistic回归发现患者的年龄、透析龄、是否糖尿病和hs-CRP均是患者发生血管钙化的独立危险因素（P〈0.01）。结论：MHD患者血管钙化现象较为常见,伴发糖尿病、高龄、长透析龄及微炎症状态可能是MHD患者血管钙化的独立危险因素。
Objective： To observe the vascular calcification, analyze the related examination results, and explore its possible influencing factor in patients with maintenance hemodialysis （ MHD ）. Methods： One hundred and two MHD patients with time more than 3 months were selected, and divided into the calcification group and non-calcification group according to the abdominal aorta calcification diagnosed by lateral plain film of abdomen. The cardiac valve calcification and carotid artery intima-media thickness（IMT） in two groups were observed by the heart and neck vascular ultrasound examination. The abdominal aorta calcification score （AACs） was analyzed according to the Kanppila, and the cardiovascular calcification index was calculated in two groups. The biochemical indicators of serum intact parathyroid hormone, high sensitive C reactive protein（ hs-CRP）, blood routine test, liver and renal function, and blood glucose,lipid, calcium, phosphorus and alkaline phosphatase alkaline phosphatase between two groups were compared. Results：There were significant differences in the age, age of dialysis, blood phosphorus, diabetic nephropathy, hs-CRP and IMT between two groups （P 〈 0.05 to P 〈 0.01 ）. The correlation analysis showed that the age, age of dialysis, blood phosphorus, hs-CRP and IMT of patients were positively correlated with AACs scores （ P 〈 0.05 to P 〈 0.01 ）. Logistic regression showed that the age, age of dialysis, diabetes and hs- CRP of patients were the independent risk factor of vascular calcification （P 〈 0.01 ）. Conclusions： The vascular calcification is more common in MHD patients, and the risk factors of vascular calcification in patients with MHD may be associated with diabetes, aging, long duration of dialysis and microinflammatory.
作者
陈忠辉
何静
CHEN Zhong-hui HE Jing(Department of Nephrology, The People＇s Hospital of Xuancheng,Xuancheng Anhui 242000, Chin)
出处
《蚌埠医学院学报》
CAS
2016年第9期1207-1210,共4页
Journal of Bengbu Medical College
关键词
血液透析
血管钙化
心血管钙化指数
糖尿病
hemodialysis
vascular calcification
cardiovascular calcification index
diabetes
